This appendix contains sample forms that can be adapted for use in foreclosure prevention programs. These forms have been developed
for non-lawyer housing counselors, but are also useful for evaluating whether a homeowner has the long-term financial wherewithal to retain a home when legal defenses may be raised.

Form: Sample Foreclosure Prevention Intake Form
This Form is designed to be filled in by an advocate or intake worker based on information supplied by the client. The form provides a complete overview of a homeowner’s finances in order to help an advocate determine what foreclosure prevention strategies are possible.

Form: Default and Delinquency Counseling Checklist

The purpose of the form is to keep track of deadlines and actions necessary to achieve a successful mortgage loan workout.Form: Sample Authorization to Release Information
In order to present a client’s full range of foreclosure prevention options, an advocate generally must obtain information about the
amount of money the loan servicer claims due. Due to valid privacy concerns for borrowers, very few servicers will release information to an advocate without written authorization from the
borrower.

Information Request for Loan Servicer This Form is a sample form that is useful for obtaining necessary information from a loan servicer about the status of a client’s loan. The information provided on this form helps determine the amounts that the servicer believes are needed to cure or pay-off the loan. In some cases, obtaining this information will crystallize a dispute the borrower may have concerning the amount due on the loan.

Sample Qualified Written Request Under RESPA

This Form is a sample ‘‘qualified written request’’ for information under the Real Estate Settlement Procedures Act (RESPA). A section of RESPA, 12 U.S.C. § 2605, provides a procedure and a remedy to obtain information from a loan servicer that fails to provide it under a more informal request. This form is an example of a ‘‘qualified written request’’ that meets the requirements of the law.

Homeowner’s Checklist for Avoiding Foreclosure
This Form is a checklist for homeowners in financial distress. It provides general suggestions and ideas on how to prepare for and work through tough times.

A.1 Sample Foreclosure Prevention Intake Form CLIENT INFORMATION Date:_________
Name(s)
Address
Home Phone
Work Phone
Best Times to Reach
Marital Status
Spouse (if any)
Children (names and ages)
Others in Household:INFORMATION ABOUT HOME BEING FORECLOSED
Address of Property If Different from Above
Names of all Co-owners w/
Address if Different
Year Purchased
Original Purchase Price
Estimate of Current Value
Number of Rooms
Owner Occupant? At purchase? Yes___ No___ Now? Yes___ No___
Multi-Family Home? Yes___ No ___
Name of tenants
Rent received
Condition Exc____ Good___ Fair___ Poor___
Major repairs needed Describe
Number of Mortgages
Other Liens
Notes:

Sample Foreclosure Prevention Counseling Reason for Default:
Client’s Statement of Objectives and Plan:Notes:
Part 2
Other Mortgages and Liens:
Yes___ No___
Describe:
Is Client In Default?/ Status/Amount of Monthly Payment:
IMPORTANT NOTE: If there are other mortgages, obtain information in Part 1 (above) for each on separate form.

1. Have client(s) made an effort to arrange a workout on their own? What result?
2. Has the client filed bankruptcy? If so when? Current status of case if still pending?
If bankruptcy is over, what result?
3. Other issues which came up during interview.
4. Questions and open issues that must be resolved.

Dear Sir or Madam:
We are working with the the Law Office of XXXXX in Las Vegas, Nevada on a plan to resolve mortgage delinquency of XYZZ. We hereby authorize you to release any and all information concerning our account to the XXXXXX at their request.
We further authorize you to discuss our case with XXXXXX.
They are working to help us address our financial problems and to propose a loss mitigation plan which is within your guidelines.
At present, we request that you fill out the request for loan information which accompanies this letter. Please return it to Beverly Bonder by fax (00000000000-00) no later than Friday February 2009. You may release additional information to the XXXX in the future without further authorization.

Dear Sir or Madam:
Ocwen Federal Bank, FSB is the servicer of our mortgage loan at the above address. We dispute the amount that is owed according to the Monthly Billing Statement and request that you send us information about the fees, costs and escrow accounting on our loan. This is a ‘‘qualified written request’’ pursuant to the Real Estate
Settlement and Procedures Act (section 2605(e)).
Specifically, we are requesting an itemization of the following:
1) a complete payment history, including but not limited to the dates and amounts of all the payments we have made on the loan to date;
2) a breakdown of the amount of claimed arrears or delinquencies;
3) an explanation of how the amount due on the Monthly Billing Statement ($1,000) was calculated and a explanation of why this amount was increased to $2,000 on August 1, 2003;
4) the payment dates, purpose of payment and recipient of any and all foreclosure fees and costs that have been charged to our account;
5) the payment dates, purpose of payment and recipient of all escrow items charged to our account since [date
Ocwen took over the servicing];
6) a breakdown of the current escrow charge showing how it is calculated and the reasons for any increase within the last 24 months; and
7) a copy of any annual escrow statements and notices of a shortage, deficiency or surplus, sent to us within the last three (3) years.
Thank you for taking the time to acknowledge and answer this request as required by the Real Estate
Settlement and Procedures Act (section 2605(e)).
Very truly yours,
Joe & Sally Consumer

Homeowner’s Checklist for Avoiding Foreclosure

You may not be having financial trouble now, but many people do have money problems at some point in their lives. This checklist is not comprehensive and is not intended to provide legal advice. If you need legal advice, you should speak with a lawyer. The best way to avoid foreclosure is to make your mortgage the first bill that you pay each month. However, that is not always possible. The following pages
provide general suggestions and ideas as to how you can prepare for and work through
tough times.

􀀀 Where is the money going?
􀂃 Create a budget that shows your current income and expenses
􀂃 Review every item on your budget
􀂃 Prepare a revised, realistic budget that you can live with until your
circumstances improve
􀀀 Increase your income.
􀂃 Collect federal and state benefits if you are eligible
􀂃 Claim the earned income tax credit if you are eligible
􀂃 Stop all voluntary deductions being taken out of your paycheck
􀂃 Consider selling unnecessary property to raise money
􀀀 Reduce your expenses.
􀂃 Review every expense for potential savings — reduce or eliminate unnecessary expenses
􀂃 Pay only for the type of phone service you need
􀂃 Cancel cable television service temporarily
􀂃 Identify ways to conserve on energy and other utilities
􀂃 Participate in a home weatherization program
􀂃 Review your homeowner’s and auto insurance policies and shop around
􀂃 Claim the owner occupant property tax exemption and others for which you are eligible
􀀀 Other Considerations
􀂃 Contact your mortgage servicer at the first sign of trouble
􀂃 Ask your utility company for budget billing so you can pay the same amount each month
􀂃 If you are behind on your utility bills, start an affordable repayment plan

After Falling Behind

􀀀 Identify the problem.
􀂃 What caused your current situation (job loss, illness, divorce, decreased income)
􀂃 How long do you expect your difficulty to last
􀂃 What specific type of help do you need
􀂃 How much can you afford to pay toward
􀀀 Communicate
􀂃 Speak with your bank’s delinquent loan or loss mitigation specialist
􀂃 Explain your situation
􀂃 Ask for a mortgage workout package
􀂃 Keep a phone log that shows the date and time of your call, who you spoke to, the person’s phone number, and what was said
􀂃 Follow up your phone call with a letter and keep a copy for yourself
􀂃 Send all letters by certified mail and keep the receipt
􀀀 Pay what you can and save the rest.
􀂃 Send to the bank as much of the mortgage payment as possible
􀂃 If the bank returns your payment, save the money and do not spend it on other bills
􀀀 Know Your Options

There are many ways the bank can help you if you fall behind on your mortgage.
Which one you choose/need and what the bank allows will depend on your individual situation.

Reinstatement: You give the bank all of the back payments you owe and start making your regular monthly payment.
Partial Reinstatement: You pay at least one-half of the back payments first and agree to a repayment plan for the rest of what you owe.

Repayment Plan: You make the regular mortgage payment plus an additional
amount toward the back payments until you are caught up (usually no longer than 12 months). If the bank sets up a repayment plan for you, make sure it is reasonable. Do not agree to a plan that will not work for you.Forbearance: The bank agrees that for a limited period of time it will accept a lower monthly payment or no monthly payment. At the end of the forbearance
agreement you must bring the account current.

Modification: The bank agrees to change one or more terms of the mortgage.

Possible changes include: reducing the interest rate, extending the term of the mortgage and adding the arrears to the unpaid principal balance of your loan.

Short Sale: The bank may let you sell the home even if you owe more than the property is worth and agree to accept the lesser amount as payment in full. You
must have a buyer and a signed purchase and sale agreement. Anyone else who has a lien on the property and the private mortgage insurer, if there is one, must also agree to the short sale.

ForeclosuresMake Whole Sale: You sell the home and the money from the sale pays off the mortgage and any other liens on the property. A make whole sale does not require the bank’s approval.

Refinance: You take out a new mortgage to pay off the old mortgage.
Sometimes it makes sense to refinance. You should contact a legitimate lender and proceed carefully. Beware of large fees and high interest rates.

Deed-In-Lieu: You cannot afford to keep the home and you give the house back to the bank. Do not ask for a deed-in-lieu when you have equity in the property
or when a short sale is possible. The bank will not accept a deed-in-lieu if there are other liens on the property.
􀀀 Documentation for A Workout (May vary from bank to bank)
􀂃 Signed and dated letter that briefly explains what happened
􀂃 Documentation of your hardship (doctor’s letters, etc.)
􀂃 One month worth of pay stubs or other proof of income
􀂃 Two most recent signed federal tax returns and W2s (3 years if self employed)
􀂃 An accurate budget showing all of your monthly income and expenses
􀂃 A list of your assets (cars, bank accounts, etc.)
􀂃 A list of your liabilities (mortgages, loans, liens, other outstanding debts)
􀂃 This package must be complete before the bank will review it
􀂃 Keep copies for your file
Other Things to Know
􀀀 Talk to a lawyer or counselor experienced in default and delinquency counseling
􀂃 If you cannot reach a solution with your bank
􀂃 If you disagree with the amount the bank says you owe
􀂃 If you wish to consider filing bankruptcy
􀀀 Foreclosures move very quickly
􀂃 Keep track of deadlines
􀂃 Do not wait until the last minute to get help
􀂃 Your rights will be cut off once the foreclosure sale takes place
􀀀 Foreclosures are public
􀂃 Foreclosure notices appear in newspapers and court records
􀂃 Some people may try to take advantage of you by offering a quick fix
􀂃 Carefully review offers to refinance or consolidate your credit card
debts with your mortgage as this may make matters worse
􀂃 Avoid deals with high interest rates and large fees
􀂃 Do not agree to sell your home to someone who claims they will lease it back to you
􀂃 Talk to a lawyer or housing counselor before you sign anything

Sample Foreclosure Prevention Counseling

􀀀 Where to go for help
􀂃 Your local non-profit housing organization
􀂃 Your mortgage company
􀂃 The U.S. Department of Housing and Urban Development (HUD) Resource List
________________________________________________________
Name and phone number of agency providing this list
________________________________________________________
Name and phone number of housing agency at city/town hall
________________________________________________________